Tutorial 30th September 2013

Tutorial.
Website.
Contact us.

https://soundcloud.com/drtmcf/30-september-2013
You can click on the title or "Tutorial" above to go to Soundcloud and access and download the tutorial.
You can also access it via Dropbox.
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You also need to let me know the e-mail address you use for the account.
I can then link your account to my Dropbox files and you can access them whenever you want.
If you don't have a Dropbox account, click on the link below.
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http://db.tt/aQGZ6IUU

I was a bit slow starting the recording, so the first bit of the laboratory discussion was missed.
I have written an answer for the station, so send your answer and I'll send mine.

The station was as follows:

Laboratory results.

Your consultant is on annual leave.

Her secretary has asked you to look through the following results and decide what action should be taken in relation to each.

+ve MSSU at booking. No symptoms.

GTT at 34 weeks. Peak level 11.5.

FBC with ­ MCV at booking.

Thrombocytopenia at booking. 50,000.

Hydatidiform mole after evacuation of suspected miscarriage.

Histology after ERPC for incomplete miscarriage: no trophoblastic tissue.

Endometrial cancer: hysteroscopy: thickened endometrium. Histology: Anaplastic malignancy.

Endometrial cancer: MR scan: reaching serosa and upper endocervical canal.

Consultant does lap drainage of normal looking ovarian cyst. Malignant cells. Nulliparous. Wants children.

HVS: trichomonas.

Clue cells on smear. 12/52 pregnant.

Antenatal discharge: endocervical swab: chlamydia

Actinomyces on smear.

Herpes in pregnancy

Severe dyskaryosis on cervical smear at booking.

Primary infertility: FSH & LH ­ at 25 on day 3 of cycle.

Primary infertility. FSH 3, LH 12 on day 3 of cycle.

Treated with cabergoline for ­ prolactin and pituitary adenoma.

+ve beta HCG.

3 cm. ovarian cyst. ­ Ca 125.

Then we had a viva about forceps. 

And finally a roleplay.

Topic. Abnormal cervical smear.

Candidate's Instructions.

This is a role-play station.

You are the SpR in the colposcopy clinic.

The patient is attending after a smear showed severe dyskaryosis.

Your tasks are to take a history and explain the investigations you propose.

Tutorial 26 September 2013.

Tutorial.
Website.
Contact us.


You can click on the title or "Tutorial" above to go to Soundcloud and access and download the tutorial.
You can also access it via Dropbox.
If you want to access the podcasts on Dropbox, you need a Dropbox account.
You also need to let me know the e-mail address you use for the account.
I can then link your account to my Dropbox files and you can access them whenever you want.
If you don't have a Dropbox account, click on the link below.
This will take you to Dropbox and it is child's play to set up an account.

http://db.tt/aQGZ6IUU

Tonight we started with a critique of an extract from the Menozac website.
The technique is to think of as many headings as possible.
Then to apply them to the document.
Send your version and I'll send mine.

Then we had a roleplay.

Candidate's Instructions.

This is a roleplay station.

You are an SpR in the booking clinic. You are about to see a woman who is at 10 weeks gestation in her second pregnancy. Her first baby was stillborn.

She has had all the routing booking issues, including investigations, dealt with by the midwife who has asked you to see her to advise about her first pregnancy and its implications for the management of this pregnancy.

Take an appropriate history, advise about the necessary investigations and how the history of stillbirth will influence the management of the pregnancy.

Then a viva on the uses of Magnesium sulphate in obstetrics.

And finally a viva on normal labour and delivery.

Be sure that you know the NICE guideline.

 

Tutorial 23 September 2013

Tutorial.
Website.
Contact us.

https://soundcloud.com/drtmcf/23-september-2013
You can click on the title or "Tutorial" above to go to Soundcloud and access and download the tutorial.
You can also access it via Dropbox.
If you want to access the podcasts on Dropbox, you need a Dropbox account.
You also need to let me know the e-mail address you use for the account.
I can then link your account to my Dropbox files and you can access them whenever you want.
If you don't have a Dropbox account, click on the link below.
This will take you to Dropbox and it is child's play to set up an account.

http://db.tt/aQGZ6IUU

Tonight only Annie and Uzma attended.
They are not sitting the exam until March.
We did a couple of vivas on the basis that these could easily change into OSCEs.
Also, the more communication practice you get, the better.
Send me your answers and I'll send mine.

Viva 1.

Examiner’s instructions.

Questions / instructions.

1.         What is the definition of ASB?

2.         What is its prevalence in the pregnant and the non-pregnant.

3.         Why do we screen for ASB in pregnancy?

4.         How do we screen for ASB in pregnancy?

5.         Which antibiotics are contraindicated in the management of UTI in pregnancy?

6.         How would you decide the antibiotic to use in a case of severe pyelonephritis?

7.         What would be your management of a woman who has recurrent ASB after apparently effective antibiotic treatment?

Viva 2.

A 55 year old woman is referred by her General Practitioner.

Candidate’s Instructions.

You are an SpR in the “one-stop” PMB clinic. You are about to see a woman with bleeding some years since her menopause.

Your task is to take an appropriate history and advise her about the investigations you feel are appropriate.

Referral letter from the General Practitioner.

Manor Lodge,

High Street,

Bestown.

BE5 S00

Re: Mrs. Mary Smith,   Age 55.

5b High Street,

Bestown.

BE5 SO1

Dear Doctor,

Please see Mrs. Smith who has had bleeding down below. It is a number of years since she reached the menopause.

Yours sincerely,

James Fewords,

General Practitioner.